許多文獻已直接或間接證明大部分抗癌危害性藥品會影響第一線工作人員的身體健康。為了預防可能因為暴露而造成的副作用,所有可能接觸這些藥品的人員應受到適當的保護措施和教育訓練,以確保工作與環境安全。許多先進國家皆訂定了危害性藥品的清單,並且據此進一步確立處理這些危害性藥品的標準,包括保護裝備與操作準則,使相關工作人員得以明確地執行,獲得適當的保護。為了建立適合本國使用之指引,本指引依據實證、最新的研究資料和可使用的設備和資源,整合跨領域專家如醫師、護理師、藥師、毒物學者、職業安全學者、衛生工程學者等的意見,再加上指引使用者的共識,發展出最適合我國國情的作業標準。本指引共分為十三個章節,包括:1)抗癌危害性藥品定義與名單;2)抗癌危害性藥品的暴露;3)環境工程與個人防護設備;4)密閉系統配藥給藥裝置;5)採購、儲存、接收、與傳送;6)藥品調配;7)給藥;8)廢棄物處理;9)潑灑處理;10)防護品質監控;11)人員教育;12)居家化學治療;13)醫療工作人員健康監控。除此之外,在附錄部分有由國內藥學界所整理的破壞口服固體製劑抗癌危害性藥品之方法建議。這是國內首次完成完整的抗癌危害性藥品防護作業指引,醫療機構可參考並據此以發展、檢討或修訂機構內之作業標準流程,以落實安全防護標準的執行和維護工作人員的健康。
Several studies have documented potential exposure to antineoplastic drugs can occur in many areas of the hospital settings. Precautions should be taken to eliminate or reduce exposure as much as possible for the health care workers who are exposed to these antineoplastic hazardous agents. This guideline was developed through multidisciplinary collaboration with inputs from physicians, nurses, pharmacists, safety and environmental experts, and doctors of occupational health. This guideline is not only based on the best available evidence and expert opinion of professionals, but also the consensus of many guideline users from various health care institutions. This guideline includes thirteen sections: 1) the definition and list of hazardous drugs; 2) the risks of hazardous drug exposure; 3) engineering control and personal protective equipment; 4) the closed system transfer devices; 5) drug procurement, storage, reception and transmission; 6) drug compounding; 7) drug administration; 8) waste management; 9) spill management; 10) continuous quality monitoring; 11) staff training and education; 12) home chemotherapy; 13) medical surveillance. In addition, recommendations for the preparation of oral antineoplastic agents for patients with enteral feeding are provided as appendix. After all, this evidence-based consensus guideline is intended to facilitate the standardization of institutional procedures for the safe handling of antineoplastic hazardous drugs in Taiwanese hospitals. Following these standard procedures will assist in minimizing unnecessary exposure and maximizing safety.